Community Assessments

This report describes survey results from over 350 lesbian, gay, bisexual and transgender individuals living in Southeastern Michigan and covers their tobacco use history and their opinions on creating more smoke-free environments in Michigan. Report made possible by a grant from the Michigan Department of Community Health.

2006: New Mexico LGBT Tobacco Community Survey

In June 2006, the New Mexico Department of Health, Stop Tobacco on My People and the University of New Mexico Health Evaluation and Research Team conducted a tobacco survey of lesbian, gay, bisexual, and transgender (LGBT) people. A total of 471 people completed the survey, 88% of whom identified as LGBT. The purpose of the survey was to gain new knowledge for improved tobacco prevention and cessation programming efforts for LGBT people; therefore, analyses that follow are limited to the LGBT participants.

This brief report was prepared by the Evaluation, Research and Development Unit at the University of Arizona.For more information contact Sylvia Ramirez at sramirez@u.arizona.edu or 520/318-7259 x 175.Funded by the Arizona Department of Health Services.

2010 West Virginia Lesbian, Gay, and Bisexual Tobacco Survey

A copy of the 2010 West Virginia Pride Festival and Bar Survey used by West Virginia Covenant House and the Tobacco Prevention and Evaluation Program at the University of North Carolina at Chapel Hill.

2012 Summit Registration Form

2012 Summit Sponsorship Packet

The 2012 LGBTQ Health Equity Summit provides a great sponsorship opportunity for your company or organization! The Summit will be held on August 14th, in Kansas City, Missouri marking the eighth anniversary of the event. Convening one day before the National Conference on Tobacco or Health, the one-day Summit is an interactive, educational, and networking event where your company or organization can reach a diverse group of individuals from across the United States, all working on health equity issues and battling tobacco use, the leading preventable cause of death in the United States. The Summit brings together more than 100 community-based gay, lesbian, bisexual, and transgender leaders, along with allies, for lively panel discussions, hands-on workshops, and strategic planning sessions.

A Blueprint for Meeting LGBT health and Human Services Needs in NYS

Frazer and Warren, 2010

Estimates of the size of the LGBT population in New York State vary. In 2004, the New York State Department of Health’s Adult Tobacco Survey included questions on sexual orientation and gender identity. It suggested that 2.6% of adults in New York State are lesbian, gay or bisexual, while 2.1% are transgender. In 2007, the New York City Department of Health and Mental Hygiene’s Community Health Survey estimated that 4.1% of people in New York City identify as lesbian, gay, or bisexual; however, this survey did not ask about transgender identities. National estimates suggest that 4.1% of the population identifies as lesbian, gay, or bisexual. However, a larger number have had sex with someone of the same gender or experience same-sex attractions.

This document seeks to inform administrators and clinicians about appropriate diagnosis and treatment approaches that will help ensure the development or enhancement of effective lesbian, gay, bisexual, and transgender (LGBT)-sensitive programs. Serving as both a reference tool and program guide, it provides statistical and demographic information, prevalence data, case examples and suggested interventions, treatment guidelines and approaches, and organizational policies and procedures.

This publication focuses on the two most important audiences for successful program development and implementation—clinicians and administrators. Section I provides an introduction for both audiences and includes information on sexual orientation, legal issues, and treatment approaches and modalities from a lesbian, gay, bisexual, and transgender standpoint. Section II is written for the practicing clinician. It offers further information on clinical issues of lesbian, gay, bisexual, and transgender clients; an introduction to strategies and methods for improving current services to LGBT individuals; and steps for starting LGBT-sensitive programs. Section III, developed for program administrators, provides an overview of the issues that need to be addressed when developing an LGBT program or when expanding current services for LGBT clients. It offers the data needed to build a strong foundation for a program, including an organizational mission and policies and procedures. It provides resources and strategies for working with managed care organizations and building alliances and cooperative arrangements to coordinate efforts on behalf of LGBT individuals so that members of the LGBT population can promote self-help programs within their own communities.

Aboriginal Two-Spirit and LGBTQ Migration, Mobility, and Health Research Project

Description

This qualitative, community-based research project explored the trajectories of migration of Aboriginal people who identify as Two-Spirit, lesbian, gay, bisexual, transgender and/or queer (LGBTQ) and the impact of mobility on health and wellness. Our focus on migration included movement from First Nation reserve communities to urban centres or rural communities (and back and forth) as well as staying or moving within one place. We were interested in the intersection between sexual and gender identities with cultural/Nation and other identities within the historical and present context of colonization in Canada.

More specifically this research project had the following objectives:

* To explore the migration paths and experiences of Aboriginal Two-Spirit and LGBTQ peoples, their experiences of health/wellness in that context, and their interactions with health and social services (including mainstream, Aboriginal and LGBTQ services).

* To generate new knowledge that may lead to future research that will be of direct benefit to LGBTQ and Aboriginal communities, Aboriginal service providers and health/social service agencies.

By Chronic Disease Prevention and Control Bureau, New Mexico Department of Health

AbstractWe examined refusal rates for sensitive demographic questions to determine whether questions on sexual orientation are too sensitive for routine use on public health surveys. We compared the percentage of active refusals in New Mexico for a sexual orientation question and 6 other sensitive demographic questions. In 2007 and 2008, refusal rates for sexual orientation questions were similar to rates for questions on race/ethnicity and weight and significantly lower than rates for questions on household income. Perceptions that sexual orientation is too controversial a topic to be included on state surveys may be unfounded. (Am J Public Health. Published online ahead of print October 21, 2010: e8-e12. doi:10. 2105/AJPH.2009.186270).

Attitudes Toward Tobacco Use and Clean Air Advocacy in the LGBT Communities of Monroe and Baton Rouge, Louisiana

Caroline Cottingham
Roger Schimberg, MPH
24 August 2010

The data from this study offered information which will hopefully help to improve public health campaigns for tobacco cessation and campaigns for Clean Air acts. Participants in the focus groups in Baton Rouge and Monroe, Louisiana, offered a wealth of responses on why they believe LGBT individuals use tobacco and methods which can help them quit. Unfortunately, the participantsâ€Ÿ responses to basic knowledge questions about tobacco use in the LGBT community, tobacco company targeting, and cessation resources suggests there may be a lack of education concerning the high rates of LGBT tobacco use, the way tobacco companies target LGBT people, and how to find resources to help themselves and/or other LGBT smokers quit. Participants also offered reasons why they support Clean Air acts and barriers to supporting these regulations on tobacco use, along with reasons why they would advocate for Clean Air acts and barriers to advocacy. Coupled with the marketing survey, which offered data on how participants receive information about the LGBT community, this information may help campaigns looking to build support and increase advocacy to pass more regulations on tobacco use in the state of Louisiana. Though some barriers must be addressed, data from the focus groups suggested that most participants already supported these laws, though they did not have the means to advocate for the laws.

Though research on tobacco use in the LGBT community has increased exponentially over the past ten years, many gaps still remain. More research would be helpful in providing comparisons between states and national LGBT tobacco use data. The narrow focus and sample of this study unfortunately limits this data, but comparisons between other state-focused studies suggests that some of the trends identified in this report may apply to more than simply Baton Rouge and Monroe, Louisiana. This study will be most helpful in addressing the direct tobacco cessation and Clean Air advocacy needs of these cities, though more research might show that this data could be used to inform tobacco cessation programs and Clean Air advocacy in other Louisiana cities and possibly other states.

In 2003-04, Field Research Corporation conducted a statewide household survey of the California lesbian, gay, bisexual, and transgender (LGBT) population for the Tobacco Control Section (TCS), Department of Health Services (DHS). The purpose was to assess tobacco-related behaviors, attitudes, and knowledge within the LGBT population; identify disparities between the LGBT and general adult populations of the State; and explore possible explanations for the most important differences.

Changing the Game: Affordable Care Act and the LGBT Community

Kellan Baker, National Coalition for LGBT HealthJeff Krehely, Center for American ProgressMarch 2011

(From Introduction and Summary) In the pages that follow, we first provide an overview of the need for health care reform, including the health disparities experienced by gay and transgender Americans that the law must address. This is followed by a brief discussion of several provisions of the Affordable Care Act that hold particular promise for improving the health and well-being of the LGBT community. Next, we investigate four major areas where efforts by LGBT advocates and their allies in each state will be key to ensuring that the new health law delivers the largest possible positive results for the LGBT community when the law is fully implemented by 2014.

In each of these four areas we include recommendations for federal officials and state governments. Briefly, those recommendations include:â€¢ Establish comprehensive and LGBT-inclusive nondiscrimination policies and practices in health insurance exchangesâ€¢ Improve our knowledge base on LGBT health disparities, by including sexual orientation and gender identity demographic questions in federal health surveysâ€¢ Recognize and include gay and transgender families in the new health law, by making sure that definitions of family are not solely based upon marriage and adoption laws that automatically exclude LGBT familiesâ€¢ Create community-based healthcare interventions that are responsive to the needs of gay and transgender people

We will examine these recommendations in more detail at the end of the paper.But first we discuss why our nationâ€™s healthcare system has been badly in need of reform, and the barriers to good, affordable care that LGBT people currently face.

A community based report which addresses the prevalence of tobacco use, awareness of use and exposure hazards, issues surrounding cessation, and attitudes toward smoke-free initiatives in Gay, Lesbian, Bisexual and Transgender communities. Relays suggestions, participant recommendations, interviews with GLBT community leaders, survey results, a review of the literature and a list of LGBT-specific smoking cessation programs across the country. December 2005.

High Tobacco Use among Lesbian, Gay, and Bisexual Populations in West Virginian Bars and Community Festivals

International Journal of Environmental Research and Public Health. 2011; 8(7):2758-2769.

Abstract: With no information on tobacco use for lesbian, gay, or bisexual (LGB) populations in West Virginia (WV), it is unclear if nationally-identified LGB tobacco disparities also exist in this State. To address this data gap, we conducted a community tobacco survey in bars and events associated with the WV Pride Parade and Festival. Trained community surveyors used electronic and paper survey instruments in bars (n = 6 ) in three WV cities and community events associated with the WV Pride Parade and Festival. We analyzed results from 386 completed surveys from self-identified LGB individuals. Tobacco use among LGB bar patrons and LGB attendees at Pride-affiliated events was elevated (45%), as was current cigarette use (41%). Users of cigars and chewing tobacco were frequently dual users of cigarettes, with 80% and 60% reporting dual use, respectively. A substantial disparity likely exists in tobacco use among LGB West Virginians. Targeted interventions addressing tobacco use among LGB West Virginians are warranted in these venues, and the addition of a demographic question on sexual orientation would improve data collection and monitoring of this disparity.

Idaho Tobacco Prevention and Control Program

LGBT Health Assessment Survey

Final Survey Report 2004

During the Spring of 2003, the Idaho Tobacco Prevention and Control Program (TPCP) contracted with United Vision for Idaho (UVI) to conduct a statewide survey of lesbian, gay, bisexual, and transgender individuals to assess the impact of tobacco use within this community. In addition to asking about tobacco-use related behaviors, the survey collected data on a wide range of health-related issues that are of concern to the LGBT community at large.

LGBT Companion Document to HP 2020

The U.S. Department of Health and Human Services took an important step as they unveiled Healthy People 2020 (HP2020), the blueprint for national public health prevention and policy goals for the next decade. For the first time LGBT (lesbian, gay, bisexual and transgender) health is recognized and there is clear acknowledgement that LGBT individuals experience health disparities that affect their health status.

New Mexicoâ€™s Progress in Collecting Lesbian, Gay, Bisexual, and Transgender Health Data and Its Implications for Addressing Health Disparities

First report in New Mexico to examine numerous health indicators by sexual orientation. Compared to straight adults, LGB adults have significantly increased rates of tobacco use, excessive alcohol use, suicidal attempts and ideation, depression, intimate partner violence, obesity, asthma, and life dissatisfaction. However, LGB adults are more likely than straight adults to report engaging in sufficient physical activity and having had an HIV test. These data provide new insight into health inequities between LGB and straight adults and are essential in prioritizing and allocating resources to address the health of LGB communities.

Prevalence and Correlates of Tobacco Use Among a Sample of MSM in Shanghai, China

Berg CJ, Nehl EJ, Wong FY, He N, Huang ZJ, Ahluwalia JS, Zheng T

Men who have sex with men (MSM) have higher smoking rates than the general population in the United States, but less is known about smoking among MSM in developing countries. Thus, we examined the prevalence and correlates of smoking among MSM in China.

Smoking prevalence was 65.9% in this sample. Recent smoking (i.e., in the past 3 months) was significantly associated with lower education, greater alcohol use, and higher LGBIS scores, after controlling for important sociodemographics. Among smokers, smoking ¡Ý10 cigarettes per day (CPD), in comparison with <10 CPD, was related to older age and lower LGBIS scores and marginally related to heavy alcohol use. Heavier alcohol consumption, lower education, and older age were also associated with smoking.

Recommendations for Inclusive Data Collection of Trans People in HIV Prevention, Care, and Services

The two page short version from the Center of Excellence for Transgender HIV Prevention's "Recommendations for Inclusive Data Collection of Trans People in HIV Prevention, Care, and Services" examines the issue of reliable inclusion of the transgender population in HIV data collection. Topics include questions to ask, helpful implementation of data collection, and resource assistance.

REPORT ON TOBACCO CONSUMPTION AMONG THE HISPANIC/LATINO LGBT POPULATION

The National Lesbian, Gay, Bisexual, Transgender (LGBT) Tobacco Control Network and the National Latino Tobacco Control Network (NLTCN) recognize that the burden of tobacco addiction has taken its toll on the LGBT and Hispanic/Latino communities. The purpose of this report is to shed light on the prevalence of tobacco use among Hispanic/Latino LGBTs, patterns, health effects and recommendations for action.

Two national networks (LGBT and NLTCN) collaborated to produce this part of a report series which is intended as a useful resource for agencies, advocates and researchers
working on tobacco control initiatives among LGBT and Hispanic/Latino communities.

With this report we intend to educate and inform researchers, policy advocates and community organizers of the importance
of addressing Latino Lesbian, Gay, Bisexual and Transgender (LGBT) tobacco disparities. Few studies have focused on the tobacco prevalence, cessation needs, or protective factors that keep Latino LGBT individuals from initiating or continuing smoking. However, given the size of these minority groups, and the health disparities of each, the Latino LGBT is at significant risk due to their double disparity. Due to the known
disparities and uncertain data on LGBT and Latino LGBT communities, we offer recommendations for researchers, policy makers and community organizations to be more inclusive of Latino LGBT communities.

SOMOS: evaluation of an HIV prevention intervention for Latino gay men

The Latino Commission on AIDS is proud of the SOMOS home-grown intervention. Unlike other HIV prevention interventions, SOMOS was designed specifically to arm Latino gay men with the tools to understand and combat homophobia. Participants went through work groups focused on culture, stigma, masculinity, identity and community. After the sessions, the participants produced a public event – an ad in a newspaper, a theater event, or a presentation at a community forum – rooted in their awareness and experience. After ten cycles, the 113 participants reported increased social connectedness, increased knowledge about HIV and STDs, and less HIV risk behaviors.

The Toronto Rainbow Tobacco Survey:A Report on Tobacco Use in Toronto's LGBTTQ Communities

The Toronto Rainbow Tobacco Survey (TRTS) gathered data from over 3,000 members of Toronto's LGBTTQ communities from April to July 2006, through outreach at LGBTTQ community events and through an online survey. Results were similar to other findings, with the LGBT population smoking at much higher rates. Recommendations include targeting tobacco control efforts at the LGBTTQ population, expanding treatment resources to address the most at-risk communities and conducting further research on the determinants of tobacco use among LGBTTQ communities.

Tobacco Control Needs in Colorado

Tobacco Control Needs of the LGBT Community in Colorado - A Priority Population Statewide Needs Assesment conducted for Colorado STEPP in July 2002. This qualitative data was gathered in order to better understand the needs of the LGBT community in terms of reducing initiation of tobacco use by youth, promoting cessation among both youth and adults, reducing exposure to tobacco smoke and to inform the development of cessation programs.

Tobacco Use Among Missouri LGBTQ 2009

The Check-Out Project: An Examination of Smoking and Tobacco Attitudes in the LGBTQ Community in Missouri

This report identifies significant tobacco-related disparities in Missouri's LGBTQ community and provides a broad description of the LGBTQ community with regards to tobacco issues.

There is a higher rate of smoking and a lower rate of successful cessation. There is a lower level of knowledge of the harmful effects of smoking and exposure to secondhand smoke, and a general lack of awareness of evidence-based cessation treatment options.

Unfortunately, there is also a significant lack of awareness of the disparities identified in this assessment. The LGBTQ community of Missouri is unaware of these disparities and the health impact of tobacco use.

Tobacco Use and Interventions among Arizona Lesbian, Gay, Bisexual, and Transgender People

This study focuses on tobacco use and intervention strategies through surveys, interviews, and focus groups. It was funded by the Arizona Department of Health Services and sponsored by southern Arizona's LGBT community center, Wingspan.

Voices of the Population Disproportionately Affected by Tobacco Use On: Tobacco Use, Tobacco Control, and the Effects of Tobacco

Voinovich Center for Leadership and Public Affairs Report sponsored by the Ohio Department of Health

Qualitative Data Gathering Through Focus Groups on Population Disproportionately Affected by Tobacco Use from 2005-2006. This document includes the studie's methodology, findings, the Focus Group script, the Informed Consent form, and recruitment material.

West Virginia Lesbian, Gay, and Bisexual Tobacco Survey

Final Report: August 11, 2010

Prepared for: West Virginia Covenant House

Prepared by: UNC School of Medicine Tobacco Prevention and Evaluation Program

This report provides an independent assessment of evidence for a LGB tobacco disparity in WV. This is one of the first and most comprehensive studies of LGB tobacco use in Appalachia. To identify rates of tobacco use for LGB West Virginians, the UNC Tobacco Prevention and Evaluation Program conducted two pilot surveys of tobacco use in LGB populations at bars and community events.

Year one LGBT Tobacco Prevention and Control Focus Groups Data

Year one and year two of the LGBT Tobacco Prevention and Control Program were focused on the Tobacco Program staff visiting LGBT Community Centers across the country to conduct focus groups. This is the qualitative data collected during that time.

Recommendations & Guides

"Qualitative Investigation of Smokers and Non-Smokers in the LGBT Market" Executive Summary

Here is a executive summary of a "Qualitative Investigation of Smokers and Non-Smokers in the LGBT Market" by Winston Stuart Associates, LTD. Included is the respondent screener and discussion guides from LGBT focus groups conducted in 2001, smokers and nonsmokers, in Sacramento and San Francisco.

2012 Summit Registration Form

2012 Summit Sponsorship Packet

The 2012 LGBTQ Health Equity Summit provides a great sponsorship opportunity for your company or organization! The Summit will be held on August 14th, in Kansas City, Missouri marking the eighth anniversary of the event. Convening one day before the National Conference on Tobacco or Health, the one-day Summit is an interactive, educational, and networking event where your company or organization can reach a diverse group of individuals from across the United States, all working on health equity issues and battling tobacco use, the leading preventable cause of death in the United States. The Summit brings together more than 100 community-based gay, lesbian, bisexual, and transgender leaders, along with allies, for lively panel discussions, hands-on workshops, and strategic planning sessions.

This document seeks to inform administrators and clinicians about appropriate diagnosis and treatment approaches that will help ensure the development or enhancement of effective lesbian, gay, bisexual, and transgender (LGBT)-sensitive programs. Serving as both a reference tool and program guide, it provides statistical and demographic information, prevalence data, case examples and suggested interventions, treatment guidelines and approaches, and organizational policies and procedures.

This publication focuses on the two most important audiences for successful program development and implementation—clinicians and administrators. Section I provides an introduction for both audiences and includes information on sexual orientation, legal issues, and treatment approaches and modalities from a lesbian, gay, bisexual, and transgender standpoint. Section II is written for the practicing clinician. It offers further information on clinical issues of lesbian, gay, bisexual, and transgender clients; an introduction to strategies and methods for improving current services to LGBT individuals; and steps for starting LGBT-sensitive programs. Section III, developed for program administrators, provides an overview of the issues that need to be addressed when developing an LGBT program or when expanding current services for LGBT clients. It offers the data needed to build a strong foundation for a program, including an organizational mission and policies and procedures. It provides resources and strategies for working with managed care organizations and building alliances and cooperative arrangements to coordinate efforts on behalf of LGBT individuals so that members of the LGBT population can promote self-help programs within their own communities.

American Legacy Foundation Final Report

American Legacy Foundation final report on LGBT forum - in-depth recommendations for working within LGBT's: Examples include a call for immediate scientific research, incorporation of LGBTs into mainstream anti-tobacco work, understanding how LGBTs are targeted.

Attitudes Toward Tobacco Use and Clean Air Advocacy in the LGBT Communities of Monroe and Baton Rouge, Louisiana

Caroline Cottingham
Roger Schimberg, MPH
24 August 2010

The data from this study offered information which will hopefully help to improve public health campaigns for tobacco cessation and campaigns for Clean Air acts. Participants in the focus groups in Baton Rouge and Monroe, Louisiana, offered a wealth of responses on why they believe LGBT individuals use tobacco and methods which can help them quit. Unfortunately, the participantsâ€Ÿ responses to basic knowledge questions about tobacco use in the LGBT community, tobacco company targeting, and cessation resources suggests there may be a lack of education concerning the high rates of LGBT tobacco use, the way tobacco companies target LGBT people, and how to find resources to help themselves and/or other LGBT smokers quit. Participants also offered reasons why they support Clean Air acts and barriers to supporting these regulations on tobacco use, along with reasons why they would advocate for Clean Air acts and barriers to advocacy. Coupled with the marketing survey, which offered data on how participants receive information about the LGBT community, this information may help campaigns looking to build support and increase advocacy to pass more regulations on tobacco use in the state of Louisiana. Though some barriers must be addressed, data from the focus groups suggested that most participants already supported these laws, though they did not have the means to advocate for the laws.

Though research on tobacco use in the LGBT community has increased exponentially over the past ten years, many gaps still remain. More research would be helpful in providing comparisons between states and national LGBT tobacco use data. The narrow focus and sample of this study unfortunately limits this data, but comparisons between other state-focused studies suggests that some of the trends identified in this report may apply to more than simply Baton Rouge and Monroe, Louisiana. This study will be most helpful in addressing the direct tobacco cessation and Clean Air advocacy needs of these cities, though more research might show that this data could be used to inform tobacco cessation programs and Clean Air advocacy in other Louisiana cities and possibly other states.

Best Practices for Asking Questions about Sexual Orientation on Surveys

Created by the Sexual Minority Assessment Research Team (SMART), a multidisciplinary and multi-institutional collaboration

November 2009

In 2003 the Ford Foundation began funding a multi-year project that sought to increase the quantity and quality of data on gay, lesbian, and bisexual people, and, by extension, on heterosexual people. Over a five-year period, many researchers participated in the expert panel funded by he grant, thus contributing to the knowledge embodied in this report. This multidisciplinary expert panel pooled decades of knowledge and experience, conducted new methodological research, and met with many survey specialists to identify the best scientific approaches to gathering data on sexual orientation. This panel, known collectively as the Sexual Minority Assessment Research Team (SMART), met regularly to discuss these data issues. By “sexual minority,” we mean people who are attracted to or have had experience with same-sex sex partners, or someone who identifies as lesbian, gay, or bisexual.

The National Gay and Lesbian Task Force Policy Institute, the Fenway Institute at Fenway Community Health in Boston, Mass., and BiNet USA created this report to answer these questions and offer a model practice HIV/STI prevention program that successfully educates bisexuals and those who have sex with both men and women but do not identify as bisexual.

We created this publication because sexual health issues affecting bisexuals have been largely ignored and under-represented in discussions of heterosexual and/or lesbian, gay and transgender health. Bisexual men and women are expected to have the same health concerns as either heterosexuals or gay men and lesbians, and therefore their unique concerns are seldom addressed.

This publication is designed to meet the needs of many populations. For journalists, researchers, counselors and anyone seeking to better understand bisexuality and HIV/STI prevention, we describe bisexuality and HIV/STI transmission, and offer language for understanding and explaining these trends clearly and accurately. For staff of HIV/STI prevention programs, bisexual activists, public health departments and funders we detail existing programs’ challenges and offer solutions.

Changing the Game: Affordable Care Act and the LGBT Community

Kellan Baker, National Coalition for LGBT HealthJeff Krehely, Center for American ProgressMarch 2011

(From Introduction and Summary) In the pages that follow, we first provide an overview of the need for health care reform, including the health disparities experienced by gay and transgender Americans that the law must address. This is followed by a brief discussion of several provisions of the Affordable Care Act that hold particular promise for improving the health and well-being of the LGBT community. Next, we investigate four major areas where efforts by LGBT advocates and their allies in each state will be key to ensuring that the new health law delivers the largest possible positive results for the LGBT community when the law is fully implemented by 2014.

In each of these four areas we include recommendations for federal officials and state governments. Briefly, those recommendations include:â€¢ Establish comprehensive and LGBT-inclusive nondiscrimination policies and practices in health insurance exchangesâ€¢ Improve our knowledge base on LGBT health disparities, by including sexual orientation and gender identity demographic questions in federal health surveysâ€¢ Recognize and include gay and transgender families in the new health law, by making sure that definitions of family are not solely based upon marriage and adoption laws that automatically exclude LGBT familiesâ€¢ Create community-based healthcare interventions that are responsive to the needs of gay and transgender people

We will examine these recommendations in more detail at the end of the paper.But first we discuss why our nationâ€™s healthcare system has been badly in need of reform, and the barriers to good, affordable care that LGBT people currently face.

Coming Out about Smoking: Tobacco Use in the LGBTQ Young Adult Community

NYAC has long been the go to group for some great resources for pushing back against LGBTQ youth tobacco use, and they've done it again here. Please take a gander at their fascinating new report on LGBTQ youth tobacco attitudes, complete with smart and savvy recommendations. There's lots to learn from in this report. Two things I found especially fascinating were that 20% of people who said they were 'nonsmokers' admitted to smoking socially; and that only 63% of LGBTQ youth said their sexual orientation was LGB (I know at least a dozen survey researchers who'll wail and gnash their teeth at this news). But mostly, let's get this out far and wide, because LGBTQ youth tobacco control is severely underfunded and powered. Unless we want to be doing this work in 20 more years, please help us spread these findings and strategies to all the groups that can make them happen. Great job NYAC!

COMMENTS ON THE NATIONAL PREVENTION AND HEALTH PROMOTION STRATEGY (NATIONAL PREVENTION STRATEGY

Comments as listed in response to the National Prevention Strategy online submission questionnaire

Submitted by Scout, Ph.D and Emilia Dunham of The Network for LGBT Health Equity on December 5, 2010

This draft was developed as the result of a September 15, 2010 meeting that the Surgeon General convened of the National Prevention and Health Promotion Council (the Council). They agreed on the framework for the National Prevention and Health Promotion Strategy (National Prevention Strategy) which includes the Vision, Goals, and Strategic Directions. The Council will use the framework to guide development of the National Prevention Strategy.

Consultant Directory Listings, September 2009 Edition

Complementary to our Reachout Directory, this document allows you to see what the expertise and past projects are for the consultants who identified themselves as working within the realm of the LGBT community and/or tobacco control.

The Department of Veterans Affairs Assistant Secretary for Human Resources Administration has sent out a memo celebrating Pride. The focus is on employees, not veterans â€“ and employees are not able to get health benefits for partners â€“ that said, it is a refreshing step in the right direction

Executive Summary: How Tobacco Smoke Causes Disease

December 9, 2010, U.S. Surgeon General Regina M. Benjamin, MD, MBA, released a comprehensive scientific report that details new findings on how tobacco smoke damages the human body and leads to disease and death.

Flavored Disease and Death for Minorities: Why the FDA Must Ban Menthol Cigarettes

Center for American Progress Brief - May 2011

by Aisha C. Moodie-Mills

Introduction: The U.S. Food and Drug Administration is currently considering a ban on the sale and distribution of menthol cigarettes in the United States—a measure that could save thousands of lives each year and drastically cut elevated smoking-related health problems experienced by African Americans as well as lesbian, gay, bisexual, and transgender
Americans who often bear the brunt of smoking-related diseases.

This further continues to discuss the background of this problem and highlights how:

GLBT Community Center of Colorado'sSmokeFree Case Study

In 2005 the State of Colorado passed Constitutional Amendment 35, increasing tobacco tax from .20 to 84 cents per pack. All new revenue, approximately $189 million per year, was designated for health related purposes including approximately $25 million earmarked for tobacco control efforts. As part of the enabling legislation, at least 15% of the funding coming into the tobacco control program had to be used to address those with higher than average tobacco related burdens. Based upon national data, the gay, lesbian, bisexual, and transgender (GLBT) population was designated by the State Tobacco Education and Prevention Partnership (STEPP) as a disparate health community launching a statewide effort of tobacco reduction within the GLBT community.

This Case Study provides a summary and highlights of Colorado's SmokeFree GLBT project as their movement begins to reverse decades of tobacco industry targeting, marketing, and resulting addiction within the GLBT community.

The report discusses:
*The benefits of helping smokers quit
*Describes comprehensive cessation benefits
*The role of the American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act of 2010 (PPACA)
*Next steps for states to take

Joint Statement Recommendations to Include Populations Affected By Disparities in Health Funding Awards

Joint statement by the National Networks for Tobacco Control and Prevention Allied Consortium prepared to help give guidance on how to substantively include disparity populations in health RFAs. Attached to the short initial statement are suggested language changes to a series of 3 recent federal RFAs, for the Communities Putting Prevention to Work awards. These are meant to be a guide for future RFA development.

LGBT Companion Document to HP 2020

The U.S. Department of Health and Human Services took an important step as they unveiled Healthy People 2020 (HP2020), the blueprint for national public health prevention and policy goals for the next decade. For the first time LGBT (lesbian, gay, bisexual and transgender) health is recognized and there is clear acknowledgement that LGBT individuals experience health disparities that affect their health status.

LGBT HEALTH AND HUMAN SERVICES EVALUATION TOOLKIT2011

Prepared byM. Somjen FrazerCathy Roche &Chloe MirzayiStrength In Numbers Consulting Groupfor the AIDS Institute of the New York State Department of Health

This Indicator Workbook is designed to provide you with a starting toolkit for evaluating some of the aspects of your program that may be difficult to measure. This workbookprovides sample survey scales for indicators from four main categories defined in detail below: health, social support, self-efficacy, and cultural competency. In addition, we provide samples of survey "nuts and bolts," the basic information you should include in any survey.

Citation: Frazer, M. Somjen, Roche, Cathy and Mirzayi, Chloe. (2011). LGBT Health and Human Services Evaluation Toolkit. Strength In Numbers Consulting Group for the AIDS Institute of the New York State Department of Health: Brooklyn, NY and Albany, NY

Smoking is the leading cause of preventable illness and death in the country. It is the primary cause of two of the deadliest lung diseases: lung cancer (which causes more American deaths than any other cancer), and chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the nation. Since the smoking rate within the Lesbian, Gay, Bi-Sexual, and Transgender (LGBT) community is roughly double that of the general population, members of the LGBT community are at greater risk of contracting and suffering from other tobacco-related health threats such as heart attacks and strokes1. In order to better understand the root causes of the more prevalent use of tobacco in the LGBT community and find effective solutions to this deadly threat, the Arkansas Department of Health (ADH) Tobacco Prevention and Cessation Program (TPCP) developed an online survey to be completed by LGBT support organizations between October 19 and November 15, 2010.

National Networks Joint Policy Statement 2010

National Stakeholder Strategy for Achieving Health Equity

The National Stakeholder Strategy for Achieving Health Equity provides a common set of goals and objectives for public and private sector initiatives and partnerships to help racial and ethnic minorities -- and other underserved groups -- reach their full health potential.

The strategy -- a product of the National Partnership for Action (NPA) -- incorporates ideas, suggestions and comments from thousands of individuals and organizations across the country. Local groups can use the National Stakeholder Strategy to identify which goals are most important for their communities and adopt the most effective strategies and action steps to help reach them.

Network public comment / testimony on the National Health Equity Plan draft of 2010

The Network submitted this line by line suggested enhancements for the draft National Partnership for Action Plan to Achieve Health Equity back in 2010. We're happy to say many of our suggestions were included and the plan is much better!

With Sharing our Lessons we hope to highlight activities happening in the field of LGBT tobacco control and share the stories and voices of those fighting the good fight against big tobacco. We believe that a community driven network must be at the core of the movement and that sharing our stories is an important way to keep the community strong. Please contact us if you know of a project that can be featured in future issues of this publication. lgbttobacco@gmail.com

Preemption: Tobacco Control's #1 Enemy

August 2004

Americans for Non-Smokers Rights

Preemption, as most tobacco control advocates know, is a dirty tactic that removes communities’ right to enact local smokefree air laws. In other words, if a preemption law passes at the state level, your decision-making body (city council, board of health) will lose the power to enact a smokefree law. Sound like a raw deal? It is for us, but the tobacco industry wants nothing more.

Promising Practices for Comprehensive Tobacco Control Program identifying and eliminating LGBT disparities

Stemming from the Network's Tobacco Control Summits, the document highlights the measures states and localities should take when addressing tobacco control and wellness in LGBTQ populations. Steps include community inclusion and funding in policy planning, monitoring impact of tobacco on LGBTs, establishing culturally competent and tailored standards for statewide programs, and disseminating findings or lessons learned from programs. Rationale and ideas to meet each criterion are illustrated in this easy-to-use document.

Recommendations from the American Legacy Foundation - Final Report

American Legacy Foundation recommendations from the LGBT Forum in Nov. 2000, Healthy People 2010, and National Association of LGBT Community Centers Final Report for the CDC (July 2003) in the areas of prevention; cessation; research and evaluation, policy/advocacy and inclusion; education and media; capacity building, funding and support.

REPORT ON TOBACCO CONSUMPTION AMONG THE HISPANIC/LATINO LGBT POPULATION

The National Lesbian, Gay, Bisexual, Transgender (LGBT) Tobacco Control Network and the National Latino Tobacco Control Network (NLTCN) recognize that the burden of tobacco addiction has taken its toll on the LGBT and Hispanic/Latino communities. The purpose of this report is to shed light on the prevalence of tobacco use among Hispanic/Latino LGBTs, patterns, health effects and recommendations for action.

Two national networks (LGBT and NLTCN) collaborated to produce this part of a report series which is intended as a useful resource for agencies, advocates and researchers
working on tobacco control initiatives among LGBT and Hispanic/Latino communities.

With this report we intend to educate and inform researchers, policy advocates and community organizers of the importance
of addressing Latino Lesbian, Gay, Bisexual and Transgender (LGBT) tobacco disparities. Few studies have focused on the tobacco prevalence, cessation needs, or protective factors that keep Latino LGBT individuals from initiating or continuing smoking. However, given the size of these minority groups, and the health disparities of each, the Latino LGBT is at significant risk due to their double disparity. Due to the known
disparities and uncertain data on LGBT and Latino LGBT communities, we offer recommendations for researchers, policy makers and community organizations to be more inclusive of Latino LGBT communities.

Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC

Problem: Sexual minority youths are youths who identify themselves as gay or lesbian, bisexual, or unsure of their sexual identity or youths who have only had sexual contact with persons of the same sex or with both sexes. Population-based data on the healthrisk behaviors practiced by sexual minority youths are needed at the state and local levels to most effectively monitor and ensure the effectiveness of public health interventions designed to address the needs of this population.

Reporting Period Covered: January 2001-June 2009

Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, dietary behaviors, physical activity and sedentary behaviors, and weight management) and the prevalence of obesity and asthma among youths and young adults. YRBSS includes state and local schoolbased Youth Risk Behavior Surveys (YRBSs) conducted by state and local education and health agencies. This report summarizes results from YRBSs conducted during 2001–2009 in seven states and six large urban school districts that included questions on sexual identity (i.e., heterosexual, gay or lesbian, bisexual, or unsure), sex of sexual contacts (i.e., same sex only, opposite sex only, or both sexes), or both of these variables. The surveys were conducted among large population-based samples of public school students in grades 9-12.

Interpretation: Sexual minority students, particularly gay, lesbian, and bisexual students and students who had sexual contact with both sexes, are more likely to engage in health-risk behaviors than other students.

Public Health Action: Effective state and local public health and school health policies and practices should be developed to help reduce the prevalence of health-risk behaviors and improve health outcomes among sexual minority youths. In addition, more state and local surveys designed to monitor health-risk behaviors and selected health outcomes among population-based samples of students in grades 9-12 should include questions on sexual identity and sex of sexual contacts.

Social ecology of tobacco surveillance data for sexual and gender minority populations

State LGBT Tobacco Disparities Best Practices

A compiled list of tested strategies that states have used to address LGBT tobacco disparities. These strategies represent the current best practices available to address LGBT tobacco disparities and we strongly encourage states to adopt as many of these best practices as possible.

Surgeon General 2010 Clinician Booklet: What to Tell Your Patients About Smoking

Surgeon General 2010 Clinician Booklet: What to Tell Your Patients About Smoking

This one-page fact sheet summarizes the findings from How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. This fact sheet features smoking-attributable chronic disease information as well as “how to quit” information from the Clinical Practice Guidelines (published by the U.S. Agency for Healthcare Research and Quality). The fact sheet provides simple talking points and key information to help medical providers talk to their patients about quitting tobacco use.

Surgeon General 2010 Full Report: How Tobacco Smoke Causes Disease

The Biology and Behavioral Basis for Smoking-Attributable Disease

U.S. Department of Health and Human Services

A Report of the Surgeon General

Thursday, December 9, 2010, U.S. Surgeon General Regina M. Benjamin, MD, MBA, released a comprehensive scientific report that details new findings on how tobacco smoke damages the human body and leads to disease and death.

The Health of Lesbian, Gay, Bisexual, and Transgender (LGBT) People: Building a Foundation for Better Understanding Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations; Institute of Medicine

The Network's Comments on the National Prevention Strategy Draft

An important component of the Affordable Care Act, the National Prevention, Health Promotion, and Public Health Council (National Prevention Council) brings together seventeen federal departments and agencies to plan and coordinate prevention efforts across the government and the nation through the development of the National Prevention and Health Promotion Strategy (National Prevention Strategy).

Tool Kit for LGBTQ Organizations

If you're seeking funding, check this out. We dispel myths about tobacco control, have created a guide on where to look for funding opportunities, and included examples of model programs. It also includes suggestions on how to prepare a competitive proposal.

Tool Kit for State Funders

Our introduction is designed to orient state funders to LGBTs, provide you with links to LGBT organizations in your state, and highlight example programs. Weâ€™ve also included best case scenarios for engaging competitive LGBT applicants for tobacco control funding.

These are slides from our first ever co-lead Webinar with Network member Susan Forrest and Dr. Talia Bettcher who co-presented a Webinar on Transgender Inclusion in Health and Community organizations/agencies serving, or that could potentially serve, transgender people. Types of agencies included Departments of Health, cessation groups, LGBT organizations, Tobacco Control organizations, Health Centers, etc. With their cultural competency training experience, Talia and Susan presented on how organizations can be more inclusive of the transgender community in general with mention of how even LGBT-focused cessation programs can be more inclusive of trans individuals.

State Disparities Plans

A Blueprint for Meeting LGBT health and Human Services Needs in NYS

Frazer and Warren, 2010

Estimates of the size of the LGBT population in New York State vary. In 2004, the New York State Department of Health’s Adult Tobacco Survey included questions on sexual orientation and gender identity. It suggested that 2.6% of adults in New York State are lesbian, gay or bisexual, while 2.1% are transgender. In 2007, the New York City Department of Health and Mental Hygiene’s Community Health Survey estimated that 4.1% of people in New York City identify as lesbian, gay, or bisexual; however, this survey did not ask about transgender identities. National estimates suggest that 4.1% of the population identifies as lesbian, gay, or bisexual. However, a larger number have had sex with someone of the same gender or experience same-sex attractions.

Addressing Tobacco in Colorado’s Socio-Economically Disadvantaged Communities: A Community Blueprint for Action

A report prepared by the Colorado Community Coalition for Health Equity
July 201

To embrace the goal of reducing high tobacco use rates among SED Coloradans, 11 Colorado nonprofit and local health agency organizations came together with the intention of creating a strong, diverse coalition having the capacity to better serve SED tobacco users across Colorado. To increase their understanding of the SED tobacco users, a needs assessment and inventories of community assets were developed to gain insight and knowledge about the motivations, attitudes, beliefs, existing resources and service access points of the SED populations. This base of knowledge enabled the Coalition and community stakeholders to develop a plan for addressing tobacco-related health
disparities that exists in SED communities, and to provide a blueprint for building the capacity of the communities involved.
Project Overview Process evaluation measures were designed to ensure stakeholder satisfaction throughout the project, as well as, to assess organizational knowledge of the SED populations and confidence to meet education, cessation and service needs. Data for the project was collected using focus groups comprised of participants from SED populations; interviews with local and national experts; meetings with local Community Advisory Committees made up of SED service providers who developed community asset inventories; and a literature review to provide lessons learned and promising practices. The review also assisted in the development of cultural considerations for the diverse
segments of the SED population. All data collection methods were assessed for cultural competency. This report includes cultural considerations of LGBT, Black/African American, American Indian, Latino/Hispanic and Rural Communities.

Attitudes Toward Tobacco Use and Clean Air Advocacy in the LGBT Communities of Monroe and Baton Rouge, Louisiana

Caroline Cottingham
Roger Schimberg, MPH
24 August 2010

The data from this study offered information which will hopefully help to improve public health campaigns for tobacco cessation and campaigns for Clean Air acts. Participants in the focus groups in Baton Rouge and Monroe, Louisiana, offered a wealth of responses on why they believe LGBT individuals use tobacco and methods which can help them quit. Unfortunately, the participantsâ€Ÿ responses to basic knowledge questions about tobacco use in the LGBT community, tobacco company targeting, and cessation resources suggests there may be a lack of education concerning the high rates of LGBT tobacco use, the way tobacco companies target LGBT people, and how to find resources to help themselves and/or other LGBT smokers quit. Participants also offered reasons why they support Clean Air acts and barriers to supporting these regulations on tobacco use, along with reasons why they would advocate for Clean Air acts and barriers to advocacy. Coupled with the marketing survey, which offered data on how participants receive information about the LGBT community, this information may help campaigns looking to build support and increase advocacy to pass more regulations on tobacco use in the state of Louisiana. Though some barriers must be addressed, data from the focus groups suggested that most participants already supported these laws, though they did not have the means to advocate for the laws.

Though research on tobacco use in the LGBT community has increased exponentially over the past ten years, many gaps still remain. More research would be helpful in providing comparisons between states and national LGBT tobacco use data. The narrow focus and sample of this study unfortunately limits this data, but comparisons between other state-focused studies suggests that some of the trends identified in this report may apply to more than simply Baton Rouge and Monroe, Louisiana. This study will be most helpful in addressing the direct tobacco cessation and Clean Air advocacy needs of these cities, though more research might show that this data could be used to inform tobacco cessation programs and Clean Air advocacy in other Louisiana cities and possibly other states.

A Report from the Wisconson Tobacco Control Disparities workgroup to the Department of Health and Family Services (2002). Discusses background information, workgroup roles, goals and strategies, evaluation techniques and a logic model.

In 2003-04, Field Research Corporation conducted a statewide household survey of the California lesbian, gay, bisexual, and transgender (LGBT) population for the Tobacco Control Section (TCS), Department of Health Services (DHS). The purpose was to assess tobacco-related behaviors, attitudes, and knowledge within the LGBT population; identify disparities between the LGBT and general adult populations of the State; and explore possible explanations for the most important differences.

A community based report which addresses the prevalence of tobacco use, awareness of use and exposure hazards, issues surrounding cessation, and attitudes toward smoke-free initiatives in Gay, Lesbian, Bisexual and Transgender communities. Relays suggestions, participant recommendations, interviews with GLBT community leaders, survey results, a review of the literature and a list of LGBT-specific smoking cessation programs across the country. December 2005.

The report discusses:
*The benefits of helping smokers quit
*Describes comprehensive cessation benefits
*The role of the American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act of 2010 (PPACA)
*Next steps for states to take

Idaho Tobacco Prevention and Control Program

LGBT Health Assessment Survey

Final Survey Report 2004

During the Spring of 2003, the Idaho Tobacco Prevention and Control Program (TPCP) contracted with United Vision for Idaho (UVI) to conduct a statewide survey of lesbian, gay, bisexual, and transgender individuals to assess the impact of tobacco use within this community. In addition to asking about tobacco-use related behaviors, the survey collected data on a wide range of health-related issues that are of concern to the LGBT community at large.

A statewide Tobacco Disparities Strategic Planning Committee developed the Missouri Tobacco-Related Disparities Strategic Plan. Missouri will use this plan as a part of the Missouri Comprehensive Tobacco Use Prevention Plan to guide future activities to reduce tobacco-related disparities.

National Stakeholder Strategy for Achieving Health Equity

The National Stakeholder Strategy for Achieving Health Equity provides a common set of goals and objectives for public and private sector initiatives and partnerships to help racial and ethnic minorities -- and other underserved groups -- reach their full health potential.

The strategy -- a product of the National Partnership for Action (NPA) -- incorporates ideas, suggestions and comments from thousands of individuals and organizations across the country. Local groups can use the National Stakeholder Strategy to identify which goals are most important for their communities and adopt the most effective strategies and action steps to help reach them.

An action plan to address tobacco-related health disparities among at-risk, culturally diverse, and underserved populations called "Empowering cross-cultural communities to take action to overcome tobacco-related health disparities." The Cross-Cultural Tobacco Control Alliance is a newly-formed statewide partnership consisting of various communities that has emerged to enhance Ohio's ability to improve adverse health outcomes related to tobacco use and secondhand smoke exposure.